YF4-82694-82567
4 vaccinations
6 coded responses
51 check-ins
6 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 36-40
- ZIP prefix
- 331 / FL
- Registered
- 2021-04-11
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Registered dependents
KFA-11141-87040
Child or adolescent in my care · Female · 2022-06-29
9D4-13517-54765
Child or adolescent in my care · Male · 2022-06-29
Timeline
-
2021-04-09
Dose 1 — Moderna
-
2021-04-11
Registered in v-safe
- 2021-04-11
- 2021-04-12
- 2021-04-13
- 2021-04-14
- 2021-04-15
- 2021-04-16
-
2021-04-23
Survey response — day 14, dose 1MedDRA: Erythema, Injection site rash, Rash — Feeling: GoodFree text: Small red rash near injection site. No pain or irritation, just red skin. The rash went way after about 2 days.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-30
-
2021-05-07
Dose 2 — Moderna
- 2021-05-07
-
2021-05-08
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-05-09
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-05-10
- 2021-05-11
- 2021-05-12
- 2021-05-13
- 2021-05-14
- 2021-05-21
- 2021-05-28
-
2021-06-04
Survey response — day 28, dose 2MedDRA: Chills, Fatigue, Myalgia, SARS-CoV-2 test negative — Feeling: GoodFree text: Slight fever (99.7 F), fatigue, muscle aches, and chills. Lasted ~12 hrs on May 30. Similar to after 2nd shot but milder. Tested negative on June 1 (nasal swab PCR test).MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-11
- 2021-06-18
- 2021-08-06
-
2021-11-05
Survey response — 6 months, dose 2MedDRA: Conjunctivitis, Nasopharyngitis, Rhinorrhoea — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Pink eye, runny nose (two separate events). Most likely got poked in eye by my kids and then caught a cold from them.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-05
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-11-08
-
2021-12-02
Dose 3 — Moderna
-
2021-12-03
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-12-04
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-12-05
- 2021-12-06
-
2021-12-07
Survey response — days 1–6 daily, dose 3MedDRA: Nasal congestion, Rhinorrhoea — Feeling: FairFree text: Nasal congestion and runny noseMedDRA releases: 2024-11 · check-in free text available
-
2021-12-08
Survey response — days 1–6 daily, dose 3MedDRA: Nasal congestion, Rhinorrhoea — Feeling: GoodFree text: Nasal congestion and runny nose (same as yesterday)MedDRA releases: 2024-11 · check-in free text available
- 2021-12-09
- 2021-12-16
- 2021-12-23
-
2021-12-30
Survey response — day 28, dose 3MedDRA: Productive cough, Rhinorrhoea — Feeling: FairFree text: Runny nose, phlegm-y coughMedDRA releases: 2024-11 · check-in free text available
- 2022-01-06
- 2022-01-13
- 2022-03-03
- 2022-06-02
-
2022-10-07
Dose 4 — ModernaCo-administered: Flu
- 2022-10-07
-
2022-10-08
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Muscle or body achesAdult check-in
- 2022-10-09
- 2022-10-10
- 2022-10-11
- 2022-10-12
- 2022-10-13
- 2022-10-14
- 2022-10-21
- 2022-10-28
- 2022-11-04
- 2022-11-11
- 2022-11-18
- 2023-04-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-09 | Moderna | |
| 2 | 2021-05-07 | Moderna | |
| 3 | 2021-12-02 | Moderna | No |
| 4 | 2022-10-07 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-11-05 | Unsuccessful |
Free text
Release 7 — day 14, dose 1
Symptoms: Small red rash near injection site. No pain or irritation, just red skin. The rash went way after about 2 days.
Release 8 — day 28, dose 2
Symptoms: Slight fever (99.7 F), fatigue, muscle aches, and chills. Lasted ~12 hrs on May 30. Similar to after 2nd shot but milder. Tested negative on June 1 (nasal swab PCR test).
Release 10 — 6 months, dose 2
Symptoms: Pink eye, runny nose (two separate events). Most likely got poked in eye by my kids and then caught a cold from them.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Nasal congestion and runny nose
Systemic reaction (other): Nasal congestion and runny nose (same as yesterday)
Release 10 — day 28, dose 3
Symptoms: Runny nose, phlegm-y cough
Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".
MedDRA terms by release
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Conjunctivitis | · | · | ✓ |
| SD | Erythema | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Productive cough | · | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SRO | Nasal congestion | · | · | ✓ |
| SRO | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release